Healthcare Provider Details

I. General information

NPI: 1699060954
Provider Name (Legal Business Name): KATHRYN K HUFMEYER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN G KINNER MD

II. Dates (important events)

Enumeration Date: 06/15/2011
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 N SAINT CLAIR ST GALTER 18-200
CHICAGO IL
60611-5975
US

IV. Provider business mailing address

4498 MAIN ST STE 23
AMHERST NY
14226-3826
US

V. Phone/Fax

Practice location:
  • Phone: 312-695-8630
  • Fax:
Mailing address:
  • Phone: 716-961-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125059134
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number300925
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036135561
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: